Walking The Talk By Budgeting For Tobacco Control

Walking The Talk By Budgeting For Tobacco Control

Beyond flowery rhetoric and grand promises, the will of a government to act on a policy is first re­flected in its financial plan. Ac­tivities for the implementation of such policies are provided with a budget line followed by a full dis­bursement of the budgeted sum to empower execution.

Tobacco control in Nigeria has made commendable prog­ress despite the observed funding crunch. The enactment of the Na­tional Tobacco Control Act, 2015; the slow but eventual approval of its regulations in 2019, and the few pockets of implementation of the Graphic Health Warning (GHW) policy are testament to the thorny path of tobacco control ef­forts in the country.

However, with this progress and the seeming pro-tobacco-con­trol posturing of the Federal Gov­ernment, the establishment of a dedicated Tobacco Control Unit within the Federal Ministry of Health (the primary executor of the National Tobacco Control Act 2015) has been a glimmer of light. Unfortunately, like a finan­cial orphan, tobacco control is left out when it comes to adequately implement the budget.

The 2022 Tobacco Atlas indi­cates that nearly $2 trillion is spent annually in health care costs worldwide, causing pro­duction loss from premature death and sickness as a result of tobacco.

Nigeria has a smoking popula­tion of over 7 million people and an estimated 246 deaths weekly because of tobacco consumption. This grave public health problem continues to fester, and ordinarily should cause policymakers to lose sleep until it is wholly addressed through adequate and sustained funding of tobacco control to nip the problem.

Also, an estimated 526.4 bil­lion Naira is spent annually on the treatment of tobacco-related illnesses. All these worrisome figures present a strong case for special budgetary provisions for tobacco control.

Within the Federal Ministry of Health, it is unclear what pri­ority is given to tobacco control. It is however perceivable to the extent that there is a lukewarm attitude towards the inclusion of tobacco control as a line item in the yearly budget proposal – causing a critical funding gap for the important work. While it is expedient to allot funds for issues such as cancer, it also makes sim­ple sense to adequately apportion funds for tobacco control, with ev­idence that tobacco is one of the leading causes of several kinds of cancer.

The tobacco market in Nigeria is estimated to be worth 74.90 mil­lion USD and is projected to reach 228.36 million USD by 2025, easi­ly making it a multi-billion nai­ra market. A market that has left sickness and death in its wake.

A major share of tobacco con­trol funding is sourced externally through foreign aid. According to the strength of these foreign donors, the aid provided is gen­erous, yet they are a trickle of the sheer size of the country and are easily spread thin when a na­tional implementation drive of the National Tobacco Control Act is attempted. Note also that the government cannot and should not abdicate its responsibility of funding tobacco control or other developmental issues to foreign aid. The yawning funding gap makes the ill-intentioned dollars of the tobacco industry alluring.

The institutionalisation of to­bacco control funding will make agencies of government saddled with tobacco control full proof and inoculated from possible in­ducement and industry interfer­ence, thus strengthening tobacco control.

The full operationalisation of the Tobacco Control Fund is a quick first step towards sustain­able funding. However, to control the products and activities of the humongous tobacco industry in Nigeria, the Tobacco Control Fund alone will fall short.

Progressively increasing to­bacco taxes must be earmarked for tobacco control efforts, while also making special budgetary provisions for the same.

The most probable effects of adequate and sustained state funding of tobacco control will be a significant decrease in the smoking population, a conse­quent decrease in tobacco-related illnesses and a drop in tobacco-in­duced health costs.

The Federal Government must demonstrate good faith in tobacco control through its inclu­sion of a robust line item in the annual Appropriation Act. It is also pertinent to remark that the implementation of the National Tobacco Control Act, 2015, which is modelled on the recommenda­tions of the WHO Framework Convention on Tobacco Control (WHO-FCTC) requires a national application to be truly effective.

Finally, the National Assembly must prioritize the allotment of adequate resources for tobac­co control and duly extend its oversight to ensure that funds assigned and disbursed are judi­ciously used.

Source: Independent